Efficient delivery of health care services depends on people's ability to accurately assess the severity of their pain and seek medical care promptly when it is needed. Yet empirical studies have identified many instances in which people systematically misvalue their pain-e.g., patients experiencing heart failure may delay seeking medical attention for several hours after the onset of severe physical symptoms, often with lethal consequences. The goal of the proposed research is to investigate the psychological and neural mechanisms underlying the valuation of pain and explain why and how failures of valuation occur. Behavioral and functional neuroimaging experiments will investigate (a) the relation between different types of valuation of pain (e.g., experienced versus remembered pain, (b) the relation between individual differences in pain valuation and dispositional differences in negative affect, and (c) the neural pathways that mediate the influence of different types of pain valuation on decision-making. By advancing our understanding of the psychological and neural mechanisms involved in pain-related decision-making, the proposed experiments can potentially help to improve measurement of pain in clinical settings and develop novel interventions to enhance the quality of patients' pain-related decisions. Public health relevance: This research seeks to understand how people determine the value of their pain when making pain-related decisions. The proposed experiments have the potential to explain why it is that people often make poor decisions about pain, e.g., failing to seek prompt medical attention when experiencing severe physical symptoms. By shedding light on the mechanisms involved in pain-related decision-making, the research has the potential to improve measurement of pain in clinical settings and to develop more effective policies for identifying and treating individuals at risk for misreporting of physical symptoms.
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